Smith, Larry Ray
Smith, Larry Ray is an individual health care provider with primary practice located at 330 Hawthorne Ln , Athens GA 30606-2152. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Smith, Larry Ray can be contacted via phone (706) 613-8500.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 23506 | Georgia |
Profile Details
| NPI number | 1619953569 |
|---|---|
| LBN Legal business name | Smith, Larry Ray |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 21st, 2005 |
| Last updated | Oct 18th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619953569 | NPPES |
| Georgia | MEDICAID | 000287328O | |
| Georgia | Other | MEDICARE | |
| Georgia | MEDICAID | 000287328N |
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